Reprt t NHS Educatin fr Sctland (NES) An Explratin f the Interpretatin and Applicatin f the use f Due Regard in Pre-registratin Nursing Prgrammes March 2013 Julia A. Sctt, Directr f Learning Teaching and Quality Enhancement, University f Stirling Christine Pllck, Senir Lecturer/Subject Grup Leader, Edinburgh Napier University Margaret Cnln, Lecturer, Edinburgh Napier University Dr Maria Pllard, Academic and Prfessinal Lead fr Practice Learning, University f the West f Sctland i
CONTENTS GLOSSARY... 1 EXECUTIVE SUMMARY... 2 SECTION 1: INTRODUCTION... 6 1.1 Prject Brief... 6 1.2 Prject Aims... 6 1.3 General Overview... 8 1.4 NMC Perspective... 9 SECTION 2: LITERATURE REVIEW... 12 2.1 Aim f Literature Review... 12 2.2 Overview f Search Strategy... 12 2.3 The Scpe f the Literature Review... 12 2.4 The Applicatin and Interpretatin f the NMC SPNE and the Principle f Due Regard... 13 2.4.1 Hub and Spke Appraches t Practice Learning... 13 2.4.2 Partnership Wrking... 14 2.5 The Applicatin and Interpretatin f the NMC Standards in Relatin t Assessment and Supervisin in Practice Learning Envirnments... 15 2.5.1 Assessment and Preparatin f Mentrs... 15 2.5.2 Assessment and Primary Care... 15 2.6 The Applicatin and Interpretatin f the NMC Standards in Relatin t Assessment and Supervisin f Students by Nn-nursing Prfessinals... 16 2.7 Reviewing the Practice f Nn-nursing Prfessins in Relatin t the Assessment and Supervisin f Students... 17 2.7.1 The Scial Wrk Prfessin... 17 2.7.2 The Medical Prfessin... 17 2.8 Assessment and Supervisin in Pre-registratin Nursing Prgrammes: An Internatinal Perspective... 18 2.9 Summary f Literature Review... 19 SECTION 3: SURVEY AND DATA ANALYSIS... 20 3.1 Findings f the Natinal On-Line Survey... 20 3.2 Demgraphics... 21 3.3 Definitins and Interpretatin f Statements... 22 3.4 Invlvement f Other Registered Prfessinals in Practice Learning and Assessment... 25 3.5 Maintaining a Register, Annual Updates and Triennial Review fr Other Registered Prfessinals... 32 3.6 Plicy and Audit... 35 3.7 Case Study Examples... 36 ii
3.8 Cnclusins frm the Natinal Survey... 37 3.8.1 Clarity f Meaning f Due Regard... 37 3.8.2 Understanding f Mentr Availability... 38 3.8.3 Interpretatin f Suitably Prepared... 38 Sectin 4: RECOMMENDATIONS... 40 4.1 Intrductin... 40 4.2 Due Regard... 40 4.3 Suitable Preparatin fr Other Registered Prfessinals and Flexibility in Practice Learning... 41 4.4 Measuring Suitable Preparatin... 42 4.5 Summary f Recmmendatins... 43 SECTION 5: REFERENCES... 44 LIST OF FIGURES Figure 1: Representatin frm Higher educatin Institutins (n=18)... 21 Figure 2: Representatin frm fields f nursing (n=18)... 21 Figure 3: Rle f participant (n=18)... 22 Figure 4: Suitable preparatin fr ther registered prfessinals (n=14)... 25 Figure 5: Assessment at prgressin pint 1 by thers... 26 Figure 6: Opprtunity t learn with thers... 27 Figure 7: Other registered prfessinals supervising students in Part 1 f the prgramme (n=13)... 28 Figure 8: Other registered prfessinals supervising students in Part 2 f the prgramme (n=13)... 29 Figure 9: Other registered prfessinals supervising students in Part 3 f the prgramme (n=13)... 30 Figure 10: Other registered prfessinals assessing students in Part 1 f the prgramme (n=13)... 31 Figure 11: Other registered prfessinals assessing students in Part 2 f the prgramme (n=13)... 31 Figure 12: Other registered prfessinals assessing students in Part 3 f the prgramme (n=13)... 32 Figure 13: Database f ther registered prfessinals (n=13)... 33 Figure 14: Annual updates fr ther registered prfessinals (n=13)... 33 Figure 15: Mnitring triennial review fr ther registered prfessinals (n=13)... 34 Figure 16: Supervisin f ther registered prfessinals by registered nurses (n=13)... 34 Figure 17: Supervisin f ther registered prfessinals by registered nurses (n=12)... 35 Figure 18: Recrding f ther registered prfessinals in audits (n=12)... 35 LIST OF TABLES Table 1: Summary f wh can make assessment decisin at varius stages f pre-registratin nursing prgrammes (NMC 2011a)... 40 iii
GLOSSARY NMC SPNE SLAiP R G HEI Nursing and Midwifery Cuncil Standards fr pre-registratin nursing educatin Standards t Supprt Learning and Assessment in Practice Requirement frm the SPNE Guidance frm the SPNE Higher Educatin Institutin 1
EXECUTIVE SUMMARY The Scttish Natinal Implementatin Grup has prvided peer review and supprt acrss Sctland s Universities thrughut the develpment and implementatin f the new pre-registratin graduate nursing prgrammes, fllwing publicatin f Nursing and Midwifery Cuncil (NMC) Standards fr pre-registratin nursing educatin (SPNE) (NMC, 2010a). Central t this supprt has been a prblem slving apprach t addressing issues that emerge thrugh the implementatin prcess. With the majrity f universities nw delivering their new prgrammes it has been identified that applying Due Regard during perids f practice learning presents a number f challenges. Perceived incnsistencies in the guidance received by universities frm NMC and their agents are believed t cntribute t these challenges. In rder t develp natinal cnsistency in the apprach t interpretatin and applicatin f Due Regard, the Grup agreed t wrk cllabratively t prgress a small scale prject t measure cmpliance with, and strategies which supprt, the principle f due regard. It is hped that this prject will prvide an pprtunity fr Sctland t develp a psitin statement in relatin t Due Regard which culd be presented t NMC in due curse. As f January 2013, The Scttish Natinal Implementatin Grup is nw knwn as the Scttish Cllabratin fr the Enhancement f Pre-registratin Nursing (SCEPRN). Prject Aims 1. Review each institutin s experiences f due regard in their pre-registratin prgrammes. This includes: Institutinal interpretatin f NMC standards, recmmendatins and guidance in relatin t Due Regard hw is Due Regard measured at institutin level; Instances where HEI s believe Due Regard has been successfully applied; Instances where it has nt been pssible t apply Due Regard; Specific challenges encuntered. 2. Cnsideratin f the evidence base fr Due Regard and what additinal value this requirement brings, fr example, is due regard required t prtect the public? 3. Clarificatin f criteria used by NMC (r their agents) t measure Due Regard in preregistratin prgrammes. 2
4. Fllwing analysis f the abve activities, reprt findings and make recmmendatins t the Natinal Strategic Grup fr Practice Learning fr a Sctland wide apprach t Due Regard. This may include develpment f a psitin paper fr presentatin t the Scttish Gvernment Health Department and the NMC based n findings, cnclusins and recmmendatins arising frm the wrk. 3
Prject Design T ascertain the evidence base t supprt the principle f Due Regard a review f the literature was undertaken t cnsider the applicatin and interpretatin f the NMC (2010a) SPNE, and t determine the practice f ther health care prfessinals in the supervisin and assessment f their student bdy in practice. T prvide evidence f current practice f the applicatin f Due Regard in HEI s in Sctland, prviding pre-registratin nursing prgrammes, an n-line survey was set up, and staff with respnsibility fr practice learning were asked t participate in cmpleting the survey. Main Findings f the Literature Review It is clear frm the respnses t the survey that there is indeed a degree f incnsistency thrughut Scttish HEI s regarding the definitin f Due Regard; when applicatin f Due Regard is a requirement within pre-registratin nursing prgrammes; and the apprpriate use f suitably prepared ther registered prfessinals wh can be invlved in bth the supervisin and assessment f students. Recmmendatins Based n the literature review and the utcme f the n line questinnaire f Scttish HEI s, the fllwing recmmendatins have been made fr HEI s t cnsider in relatin t the supervisin and assessment f students in practice learning. Recmmendatin 1: Due Regard Due Regard is nly required at sign ff, hwever individual HEI s may specify ther pints in their prgramme where they wuld want the principle f Due Regard t be applied. These specific pints shuld be clearly articulated in prgramme specificatins and apprval dcumentatin. Recmmendatin 2: Suitable Preparatin T fulfil the NMC requirements t act as a mentr, the suitably prepared ther registered prfessinal must: Be aware f the learning needs, bjectives and utcmes that the student is required t meet; Have evidence f cmpleting preparatin fr supervisin r caching assciated with his/her wn prfessinal develpment; Have evidence f prfessinal assessment skills and cmpetencies frm nn-nursing prfessins; Have participated in the assessment and supervisin f students within their wn prfessin; Have been inducted int the student nurses prgramme, their mdule, and the practice assessment dcumentatin t be used t assess the student. 4
Recmmendatin 3: Flexibility in Practice Learning T prmte flexibility, a prcess is develped by which third sectr and vluntary rganisatins can be measured as suitable fr student nurse supervisin and assessment. An actin frm this wuld be that the SCEPRN shuld develp a natinal assessr s equivalency tl fr these envirnments. Recmmendatin 4: Measuring Suitable Preparatin f the Persn t act as a Mentr Suitable preparatin may be assessed/ measured by: Use f an APEL/RPL tl, such a tl t be develped fr use by all HEI s natinally in Sctland; Quality assuring the prcess using a tripartite relatinship f: i. Liaisn lecturing staff wh supprt students in practice such as the Practice Educatin Facilitatrs and/r the Care Hme Educatin Facilitatrs; ii. The ther Registered Prfessinal; iii. The student; t ensure that mentrship is apprpriate. 5
SECTION 1: INTRODUCTION 1.1 Prject Brief The Scttish Natinal Implementatin Grup has prvided peer review and supprt acrss Sctland s Universities thrughut the develpment and implementatin f the new pre-registratin graduate nursing prgrammes, fllwing publicatin f Nursing and Midwifery Cuncil (NMC) Standards fr pre-registratin nursing educatin (SPNE) (NMC, 2010a). Central t this supprt has been a prblem slving apprach t addressing issues that emerge thrugh the implementatin prcess. With the majrity f universities nw delivering their new prgrammes it has been identified that applying Due Regard during perids f practice learning presents a number f challenges. Perceived incnsistencies in the guidance received by universities frm NMC and their agents are believed t cntribute t these challenges. In rder t develp natinal cnsistency in the apprach t interpretatin and applicatin f Due Regard, the Grup agreed t wrk cllabratively t prgress a small scale prject t measure cmpliance with, and strategies which supprt, the principle f due regard. It is hped that this prject will prvide an pprtunity fr Sctland t develp a psitin statement in relatin t Due Regard which culd be presented t NMC in due curse. As f January 2013, The Scttish Natinal Implementatin Grup is nw knwn as the Scttish Cllabratin fr the Enhancement f Pre-registratin Nursing (SCEPRN). 1.2 Prject Aims 1. Review each institutin s experiences f due regard in their pre-registratin prgrammes. This includes: Institutinal interpretatin f NMC standards, recmmendatins and guidance in relatin t Due Regard hw is Due Regard measured at institutin level; Instances where HEI s believe Due Regard has been successfully applied; Instances where it has nt been pssible t apply Due Regard; Specific challenges encuntered. 2. Cnsideratin f the evidence base fr Due Regard and what additinal value this requirement brings, fr example, is due regard required t prtect the public? 3. Clarificatin f criteria used by NMC (r their agents) t measure Due Regard in preregistratin prgrammes. 6
4. Fllwing analysis f the abve activities, reprt findings and make recmmendatins t the Natinal Strategic Grup fr Practice Learning fr a Sctland wide apprach t Due Regard. This may include develpment f a psitin paper fr presentatin t the Scttish Gvernment Health Department and the NMC based n findings, cnclusins and recmmendatins arising frm the wrk. 7
1.3 General Overview The prvisin f apprpriate practice learning pprtunities fr students undertaking preregistratin nursing prgrammes within the UK is regulated by the prfessinal bdy the NMC. As healthcare prvisin and services cntinue t change at a rapid pace student nurses will require t be cmpetent and increasingly cnfident at the pint f registratin t practice in any envirnment where service user s access care. Future redesign f service and service re-cnfiguratin cntinues t develp and will present bth challenges and pprtunities fr students t learn and develp in a range f practice learning areas. The current Scttish Gvernment Cnsultatin n Health and Scial Care Integratin thrughut Sctland will cnstitute further challenges, and pprtunities, fr practice learning availability fr pre-registratin nursing students. It shuld ffer students the pprtunity t engage with, and learn frm, a range f prfessinals, ther than nurses, wh are invlved in the delivery f care fr service users ut with what has been the traditinal setting. This has clear articulatin with the NMC (2010a) SPNE where there is recgnitin that inter-prfessinal learning and wrking is recgnised as enhancing the student experience and that practice learning pprtunities take place acrss a range f cmmunity, hspital and ther settings. Prgramme prviders are increasingly under pressure t utilise a diversity f practice learning experiences due t reduced capacity in traditinal hspital settings. Hwever, the questin that arises is what abut Due Regard in such practice learning envirnments? The principle f Due Regard was intrduced by the NMC in the first editin f the Standards t Supprt Learning and Assessment in Practice (SLAiP) (NMC 2006) and was initially intrduced in respnse t a shrtage f practice teachers available t assess and supervise students, as well as enabling the develpment f practice learning experiences that reflected cntemprary health and scial care prvisin. Hwever since the intrductin f the principle there have been several attempts by the NMC t clarify and strengthen the Due Regard prcess t enable greater flexibility in applicatin. The intrductin f the SPNE (NMC 2010a) allwed fr greater flexibility in practice learning experience and in the supervisin f students, bth directly and indirectly, with the invlvement f ther registered prfessinals being invlved in the supervisin and assessment f student nurses. Further t this the mentr nw nly needs t be available t the student 40% f the time during perids f practice learning, rather than must be available, t prvide supervisin directly r indirectly (NMC 2010a). This increased flexibility in practice learning prvisin aims t enable students t develp the skills and cmpetencies necessary t prvide high quality care in what is a rapidly changing health care envirnment. T ascertain the evidence base t supprt the principle f Due Regard a review f the literature was undertaken t cnsider the applicatin and interpretatin f the NMC (2010a) SPNE, and t determine the practice f ther health care prfessinals in the supervisin and assessment f their student bdy in practice. T prvide evidence f current practice f the applicatin f Due Regard in HEI s in Sctland, prviding pre-registratin nursing prgrammes, an n-line survey was set up, and staff with respnsibility fr practice learning were asked t participate in cmpleting the survey. This reprt aims t prvide clarity regarding the principle f Due Regard and its applicatin within pre-registratin nursing prgrammes in Sctland, thus pening up pprtunities fr students t engage in care prvisin in an increasingly diverse range f practice learning areas. 8
NMC (2010a) ffers pprtunities t students t fllw health jurneys, t learn frm thers ut with nursing, increased respnsibility and access t decisin making, and fr pprtunities t practice in mre diverse settings at the end f their prgramme. Fr student nurses t access these mre diverse pprtunities hwever, HEI s need t adpt flexibility in the supervisin f students in practice, and t invlve ther prfessinals in supprting and assessing students. 1.4 NMC Perspective The intrductin f the NMC (2010a) SPNE prvide the framewrk within which nursing prgrammes are delivered, and specify the requirements that all prgrammes must meet, including thse relating t the teaching, learning and assessment f nursing students as articulated within the Standards t Supprt Learning and Assessment in Practice (SLAiP) (NMC 2008). The SPNE set n specific requirements fr the nature r range f practice learning, ther than it must enable students t achieve their cmpetencies, but requires students t learn in a range f settings, with links t the service user s jurney reflecting the future cnfiguratin f services (NMC 2010a). The SPNE encmpasses previus advice and guidance issued frm the NMC regarding Due Regard and its implicatins fr practice learning. This includes the NMC 2007 Circular 26/2007, Applying due regard t learning and assessment in practice, and advice given within the SLAiP which incrprated the 26/2007 Circular. Hwever anmalies exist between the SLAiP and the SPNE because f the lack f cnsistency f the interpretatin and applicatin f Due Regard. This cnfusin was recgnised by the NMC in the publicatin f the 2 nd editin f the Advice and supprting infrmatin fr implementing NMC standards fr pre-registratin nursing educatin (NMC 2011a), which prvides guidance fr the SPNE, where the NMC added t and amended varius areas f the supprting advice. This updated versin included the additin f a new annexe t prvide clarificatin f hw requirements within the SLAiP apply t the SPNE (2011b). Particular reference is made t assessment f students in practice. The SLAiP advice infers that assessment in practice is nrmally made with Due Regard. Hwever the SPNE make it clear that assessment decisins can be made by any registered nurse at prgressin pints ne and tw, and culd be made by any ther registered prfessinals, wh have been suitably prepared, at prgressin pint ne. It will be up t prgramme prviders t decide when the nature f the practice learning and the learning utcmes requires assessment with Due Regard, befre the final sign ff pint. Hwever, thrughut the prgramme a registered nurse mentr r, where decisins are transferrable acrss prfessins, an apprpriate registered prfessinal, wh has been suitably prepared, can make assessment decisins. Due Regard must be applied at the end f the prgramme, at final sign ff fr registratin. This is actually the nly pint in the prgramme where Due Regard must be applied. This increased flexibility t the assessment f practice learning nw allws thers, wh d nt have Due Regard, t be invlved in practice assessment decisins thrughut each part f the prgramme. Such thers include registered nurse mentrs withut Due Regard, and apprpriate registered prfessinals wh have been suitably prepared fr the rle. Other registered prfessinals include ther healthcare prfessinals, teachers and scial wrkers. It is nly at final sign ff fr entry t the prfessinal register that Due Regard must be applied. This invlvement f thers in the supervisin and assessment prcess als articulates with the NMC requirement regarding interprfessinal learning where prgramme prviders must ensure that students have the pprtunity t learn with, and frm ther health and scial care prfessinals (R.5.7, NMC 2010a). 9
Questins then arise regarding suitable preparatin f thers and the NMC SPNE utlines what that preparatin culd entail in R. 8.2.2b and G. 8.2.2b (NMC 2010a). Furthermre the NMC n lnger requires that students must wrk with their mentr fr 40% f the time. The mentr must nw be available t the student fr 40% f the time. This change in wrding nw prvides the pprtunity fr differing supervisry rles and flexibility within a variety f practice learning areas. 10
NMC Timeline Regarding Due Regard 11
SECTION 2: LITERATURE REVIEW 2.1 Aim f Literature Review 1. T review the practice f ther Higher Educatin Institutin s in the applicatin and interpretatin f the NMC requirements relating t the principle f Due Regard. 2. T review the practice f ther health care prfessins in relatin t the assessment and supervisin f students t prepare students fr registratin. 2.2 Overview f Search Strategy The search terms utilised were: Due Regard; assessment; supervisin; nurses; practice/placement learning; NMC (2010a) Standards; ther registered prfessinals; AHP s; mentr; third sectr. The databases searched included CINAHL; Scial Care On-line; Web f Knwledge; Medline; Assia; Ggle schlar. Frm an initial search thirty eight recrds were selected as being relevant t the subject matter and twenty five f these have been included in the literature review. The inclusin criteria included all academic papers; gvernment literature and prfessinal guidance literature that fcused n prcesses f learning and assessment in relatin t the achievement f prfessinal cmpetencies; and the use f the Due Regard regulatin and/r the supervisry equivalent. Given the specific nature f the NMC nursing standards, and their recent intrductin, nly papers frm 2008 nwards were included. Exclusin criteria excluded papers that did nt hld direct relevance t assessment and supervisin in relatin t prfessinal cmpetencies; and/r did nt relate t assessment and supervisin in practice learning envirnments; and/r did nt include cntent relating t Due Regard. This led t thirteen papers being excluded. 2.3 The Scpe f the Literature Review The fcus f the review is t gain an understanding f the management f assessment and supervisin needs f student nurses in practice learning envirnments, and specifically the interpretatin f the principle f Due Regard. In additin, the review seeks t identify the way in which the NMC (2010a) SPNE, regarding the assessment and supervisin f student nurses, are interpreted and applied in practice learning. Sme creative respnses frm Higher Educatin Institutins, such as simulated learning, are ffered as a respnse. A small sample f these are included in the review, including the use f Hub and Spke cnfiguratins f practice learning, t enable student nurses t experience, in particular, inter-prfessinal learning. The Hub and Spke mdel is als referred t as a methd f respnding t the grwing health and scial care integratin agenda, and als particularly in the field f learning disability nursing, where care services are increasingly prvided by the independent sectr. 12
The regulatry requirements f ther cmparable health and scial care prfessins will be cnsidered with the aim f surcing evidence f similar examples f assessment and supervisin. Health and scial care integratin will impact n many diverse prfessinal grups, nt just nursing, and the expectatin wuld be that the regulatry requirements wuld therefre be similarly stringent as in nursing. A brief examinatin f the internatinal perspective f the assessment and supervisry requirements f nursing is als included t identify any parity in the requirements f assessment and supervisin in practice learning envirnments. Fr the purpses f this review a light tuch apprach will be given t the Midwifery perspective. 2.4 The Applicatin and Interpretatin f the NMC SPNE and the Principle f Due Regard The literature regarding the applicatin f the principle f Due Regard is sparse. Mre frequently authrs draw attentin t the limitatins impsed n practice learning thrugh the necessity t have Due Regard in place. This is highlighted by Brwn (2012) wh discusses the difficulties f applying Due Regard t child health students allcated t cmmunity health visiting placements in the final practice placement experience. Data indicates that cmmunity fcused final placements enhances the cnfidence f newly qualified nurses and increases the likelihd f students gaining first psts in a cmmunity setting (Sheltn and Harrisn 2011; Brks and Rjahn 2010). Hwever, the ratinale fr placing child health students int health visiting placement areas was als t encurage enrlment nt the ne year pst registratin health visiting prgramme. Brwn (2012) describes the cnstraints arund the sign ff perid when the regulatin Due Regard is applied, i.e. the sign ff mentr must be frm the same field f practice as the student, child health. As few health visitrs have a child health registratin, the NHS trust invlved and the assciated Apprved Educatinal Institutin (AEI) respnded t this by leading an internal cascade apprach t the training needs f the prspective mentrs. As ne methd f managing the Due Regard principle is t increase the training f mentrs, anther is t take a prgramme apprach and recnfigure the rganisatin f practice learning. 2.4.1 Hub and Spke Appraches t Practice Learning The NMC (2010a) standards fr pre-registratin nursing educatin indicate that a Hub and Spke apprach t practice learning may prvide the flexibility in learning and pprtunities fr mre innvative learning experiences. Lng placements with satellite spke experiences can supprt a tripartite apprach t assessment with supervisrs feeding back t the hub assessr with Due Regard. Rxburgh et al (2012) utline three pilt cnfiguratins f the hub and spke mdel and cnclude that rganising practice learning in this way deepens student learning and enables greater pprtunity fr mentrs t use their knwledge in a different way. Students develped strategies fr path learning, path-finding r strategic spking t achieve specific cmpetencies and fllw the patient jurney. Assessment and supervisry requirements are met by the mentr in the Hub wh wrks clsely with the individual supervisr in the Spke learning envirnment. Thus a Hub and Spke apprach may allw the flexibility the NMC (2010a) ffers, while maintaining Due Regard. Arntt (2010) describes a practice learning pilt and the pprtunities fr extending cmmunity fcused learning fr undergraduate adult nursing students. The ratinale fr the pilt is partially explained by the increasing drive fr cmmunity fcused nursing as 80% f health care jurneys begin and end in a primary care setting, the equivalent t 300 millin individual health care treatment episdes (Department f Health 2006). 13
In the pilt, sixteen students were managed within a discreet pathway f the adult prgramme and allcated t either general practice r cmmunity based learning envirnments with the aim f identifying the key skills and knwledge required t practice in a cmmunity setting. A Hub and Spke apprach is utilised t supprt the nursing students in skills develpment with students allcated t a Hub placement fr fur r five weeks with shrter spkes identified between the mentr and student and in line with the individual patient care pathway. Identifying the practice learning envirnment f general practice surgeries is described as challenging by Arntt, partly due t a lack f funding fr students attached t a general practice envirnment. In additin t this, cmmunity and general practice surgeries are nt traditinally viewed as main placements fr student nurse learning. The mentrs expressed a lack f clarity and understanding f what was expected f them, particularly in the area f assessment. In respnse, cmpetencies were mapped t the NMC Standards fr Educatin (2004). Mentrs in the Hub placement carried the verall respnsibility fr learning in the Spkes, but the duratin f the Spke, r the details f the verarching supervisin prcess, was nt explred in the paper. 2.4.2 Partnership Wrking Partnership wrking is als discussed by Clark et al (2011) as an ptin fr managing assessment and supervisin requirements. An innvative cllabratin between the University f Nttingham and Nttingham Cunty Cuncil is described where a health cmmunities fficer, emplyed by lcal scial services t wrk with individuals wh are hmeless, is supprted t prvide mentrship supprt t a student nurse. The student is taking part in a fur week practice learning experience within the first year f an undergraduate prgramme. NMC requirements state that a student nurse in the first year f the undergraduate prgramme can be supervised and assessed by anther prfessinal, prvided they are suitably prepared. The mentr was prepared thrugh the prvisin f an verview f the prgramme curriculum, an verview f the mentrship rle, as well as infrmatin abut the practice learning cmpetencies. Althugh the mentr held a teaching qualificatin she was asked t attend an educatinal activity in the university t update and refcus her teaching and learning knwledge t the nursing prfessin. In rder t find equivalency with the SLAiP (NMC 2008) fr assessment and supervisin f the student, the practice learning prfile audit was matched t the NMC Standards as well as t the Quality Assurance Agency fr Higher Educatin (2007). In cnclusin, the principle f Due Regard is given nly cursry attentin in the current literature. Only ne example is identified where alternative methds f preparing a mentr are described. It appears that prvisin f alternative practice learning des nt ccur if there is n mentr n the same part f the register as the student. There is sme discussin in the literature regarding the use f a Hub and Spke cnfiguratin which prvides pprtunities arund alternative practice learning experiences. Given that the NMC SPNE are relatively new and currently nly being embedded in HEI s it remains a relatively new area, nt yet explred in the literature. 14
2.5 The Applicatin and Interpretatin f the NMC Standards in Relatin t Assessment and Supervisin in Practice Learning Envirnments 2.5.1 Assessment and Preparatin f Mentrs Althugh the rle f the mentr is t create and prtect the quality f the learning envirnment, Glasper (2010) discusses the imprtance f the NMC requirement fr sign ff mentrs t supervise the student 40% f the wrking week thrugh direct supervisin. This regulatin came abut partially thrugh the Allitt Inquiry frm 1991 in which the behaviur f pupil nurse Beverley Allitt was fund t be extremely cncerning (The Allitt Inquiry 1994). Glasper welcmes the NMC standard that requires prspective sign ff mentrs t be supervised during the first three sign ff events. Hwever, fllwing difficulties in achieving this standard, Glasper describes the NMC ffering helpful alternatives such as bjective structured clinical bservatins, rle play and simulatin as methds t achievement fr the first tw sign ffs, and nly the third sign ff being face t face supervisin. The sign ff mentrs carry the burden f respnsibility in cnfirming cmpetency levels f the student, and althugh the NMC have stated that nly ne f the three ccasins f supervisin f a final stage student is required t be face t face t achieve sign ff status, Durham et al (2012) emphasise the imprtance f creating a develpment prgramme fr existing experienced mentrs t ensure skills are cntinually supprted and sufficiently develped t achieve sign ff status. A tw part assessment strategy was used which included an Objective Structured Clinical Assessment t measure mentrs understanding f the NMC requirements fr student learning. Similar alternative mechanisms have been described in the assessment f student nurses. Fitzgerald et al (2010) discuss the cmplexities f assessing student s clinical skills and describe the NMC Simulatin and Practice Learning Prject pilted acrss 17 universities and HEI s. The aim was t examine if simulatin culd be used t supprt the develpment f clinical skills withut causing any disadvantage t the student nurse. Using a system f cmpetency scring, they discuss the evidence fr discrepancies between mentr feedback and the cmpetency level f the student and fcus particularly n mentr skills in prviding feedback arund prfessinal values as being prblematic. The use f simulatin is cnsidered a helpful respnse t this and a supprtive resurce fr the mentrs. 2.5.2 Assessment and Primary Care The NMC has stated that there is greater ptential fr graduate nurses t mve int primary care envirnments with the SPNE and that it is the respnsibility f prgramme prviders t ensure that students have a wide range f practice learning pprtunities (NMC 2010a; 2011a). This drive twards cmmunity based practice learning is further supprted by Mdernising Nursing Careers (Department f Health 2006). This is based hwever n the assumptin that prgramme prviders have built an emphasis n cmmunity based learning int the undergraduate curriculum and that this is evident, nt just in practice learning, but als in academic learning. Sheltn and Harrisn (2011) use lcal anecdtal evidence t assert that the use f cmmunity placements fr the adult field is limited and that placement prvisin remains largely fcused n secndary care envirnments. 15
The literature suggests that the NMC standards are being interpreted precisely and withut the flexibility ffered in the Advice and Supprting Infrmatin fr Implementing NMC Standards fr pre-registratin nursing educatin (NMC 2011a). Prgramme prviders are reaching ut t previusly untapped resurces such as health visiting teams and GP practice teams but this is reliant n extensive partnership wrking between the Apprved Educatin Prvider and the lcal NHS Trust. 2.6 The Applicatin and Interpretatin f the NMC Standards in Relatin t Assessment and Supervisin f Students by Nn-nursing Prfessinals The increasing emphasis n health and scial care integratin alngside the advancing mvement f the independent and vluntary sectr is inevitably having an impact n the nature and availability f practice learning pprtunities. This is particularly evident in the field f learning disabilities in which Rse (2011) states that the NHS is in the minrity in terms f prviding emplyability t learning disability nursing students. If prgramme prviders are t stay viable and cntemprary, he argues they have t becme far mre knwledgeable abut the vluntary sectr and the independent care sectr, as well as all f thse care settings in between. This is particularly necessary as wrkfrce figures fr learning disability nurses is falling, frm 19,000 dwn t 6,600 in 2009, whilst demand fr service is rising. Rse argues that the vice f learning disability nurses will nt be heard until the NHS accepts that it is in the minrity fr emplying learning disability nurses. Learning disability nursing rles span cmmunity supprt specialists, liaisn rles between services, and secure and frensic settings, and as a result vluntary and public sectr placement learning shuld be accessed. A third sectr rganisatin interviewed as part f a recent Learning Disability Nursing Reprt prvides a cnsiderable number f student placements and is keen t cntinue t engage with the Apprved Educatinal Institutin t prmte their identity as a teaching rganisatin (Gates 2011). The Natinal UK Review f Learning Disability Nursing (Scttish Gvernment 2012) als highlighted the imprtance f wrking acrss agencies and that pre-registratin nursing prgrammes shuld be designed t reflect the persnalisatin agenda and the persn centred care apprach. Despite this there is little in the literature that reprts significant changes t the way practice learning is cnstructed in learning disability prgrammes. In additin, there is an absence f literature that describes practice learning that includes the vluntary and independent sectr. Heidinger (2009) describes an apprach t practice learning which enables a greater fcus n persn centred planning, a key cncept in learning disability nursing. The ratinale f the apprach, frm a Scttish University, was t supprt students wh undertk a ne year placement in which they are attached t a single cmmunity team. This cmmunity team prvides the primary mentr with c mentrship, adpted in additinal learning envirnments. The learning envirnments are arranged in relatin t the achievement f the NMC standards f prficiency, r by student interest, r by client need, in cntrast t mre traditinal appraches t allcatins in which the university determines the placement accrding t capacity and prximity f the students address. Unfrtunately, challenges relating t mentring students in nn NHS envirnments are nt explred in the paper but an assumptin wuld be that these wuld arise regardless. This apprach is suggestive f a Hub and Spke type f practice learning, althugh these terms are nt used by Heidinger. 16
In cnclusin, the subject f assessment by nn-nursing prfessinals is nt explred in literature despite clear evidence that an increase in expsure t nn NHS envirnments will becme an increasing necessity particularly in the learning disability field f nursing. There are indicatins that alternative methds f cnfiguring practice learning are being cnsidered by Apprved Higher Educatin Institutins, which may result in mre fcus n the assessment and supervisin by nn NHS prfessinals. 2.7 Reviewing the Practice f Nn-nursing Prfessins in Relatin t the Assessment and Supervisin f Students 2.7.1 The Scial Wrk Prfessin The 2002 degree fr qualifying scial wrkers states that 200 days must be spent in practice settings, an increase frm the previus 130 days (Department f Health 2002). Hwever all the time spent in practice is mandatry: the nly ther specificatin as t hw the time is t be used is t ensure that students have at least tw different practice settings, with at least tw service user grups, and als invlve statutry scial wrk. Research indicates that scial wrk educatin in practice experiences similar difficulties t nursing educatin in terms f challenges t the individual prfessinal supervising and assessing the student scial wrker. In a study cnducted by Waterhuse et al (2011) practice assessrs and placement supervisrs frm the BA (Hns) Scial Wrk students were prvided with questinnaires, supplemented by grup discussins, t explre factrs that hindered and supprted the assessment and supervisin prcess f scial wrk students. A range f structural, rganisatinal and develpmental recmmendatins were made as a result f the study. These included supprting scial wrk practice educatrs including mentring and buddy schemes fr newly qualified practice educatrs and prviding clear career pathways and/r incentives fr supprting student scial wrkers. 2.7.2 The Medical Prfessin Regulatin f medical educatin is detailed by specific utcmes and standards by the General Medical Cuncil (GMC) (GMC 2009). This was then supplemented by further advice frm the GMC in 2011 (GMC 2011). In 2010, fllwing the merger f the Pst Medical Educatinal Training Bard and the GMC, the GMC assumed all statutry respnsibility fr all stages f medical educatin, a change which is likely t have led t the supplementary advice. The requirements fr learning, teaching and assessment are set ut in nine separate dmains each cntaining a number f standards, and in additin t this the Educatin Strategy 2011-2013 (GMC 2011) prvides guidance t educatinal prviders abut the requirements f the curriculum. In relatin t medical students, medical educatrs are clear that all invlved in the educatin f medical students will be selected, trained, supprted and appraised (GMC 2011). Further regulatins state that medical schls must ensure that apprpriate staff develpment prgrammes are available that supprt all staff t prmte teaching and assessment skills (GMC 2009). The prfessinal regulatry bdy als emphasises the imprtance f rle mdels in the supervisin f medical students and that dctrs with respnsibility fr teaching medical students must ensure that they are prperly supervised (GMC 2009). Learning is utcme led and all students are assessed against a range f cmpetencies as in undergraduate nursing. 17
A literature review, undertaken by Millar and Archer (2010), explring the impact f wrkplace assessment as a tl fr learning in pst graduate medical educatin, describes wrkplace assessment, r what dctrs actually d in practice (p1), as a relatively new initiative. Traditinal assessments have been subjective, implicit and nn-standardized. Wrkplace assessment is usually frmative in nature and refers t any activity that assesses perfrmance in clinical practice which may include bservatin, discussin r feedback in the assessment prcess. The authrs cnclude that there is little evidence t demnstrate that there is a clear link between wrkplace assessment and perfrmance imprvement and suggest that substantial research arund this area requires t be cnducted particularly in the light f greater recertificatin prcesses. N mentin in the paper is given t matching assessment strategies against cmpetencies suggesting perhaps there is less prfessinal regulatin arund this area. An example f using practice learning experiences t cntribute t verall assessment requirements is described by Andersn and Lennx (2009). The Leicester Mdel f Interprfessinal Educatin describes a tw day curse that medical students cmplete t engage with interprfessinal learning activities where tw Schls f Medicine develped partnership wrking with lcal health prviders t supprt students in a shrt expsure t a cmmunity health setting. The assessment prcesses f the tw Schls differed but the cre learning bjectives were the same. In each case hwever, assessment and supervisin was prvided by registered medical prfessinals. In summary, the medical prfessin is mving twards greater cnsistency and bjectivity in assessment prcesses which are matched against pre-determined cmpetencies. There is little r n indicatin that prfessinals ther than the medical prfessinals are assessing medical students. 2.8 Assessment and Supervisin in Pre-registratin Nursing Prgrammes: An Internatinal Perspective The Australian Nursing Cuncil (2002) describes the prfessinal standards in the Principles fr the assessment f Natinal Cmpetency Standards. Here, an assessr is described as an individual wh is: educated in assessment f perfrmance, is experienced in the nursing perfrmance being bserved and has demnstrated skills in analysis, interpretatin and evaluatin f elements f the assessment prcess. (p.1) It des nt state that the individual has t hld a prfessinal registratin. Recently there has been a shift in emphasis away frm assessment simply based n knwledge and the use f checklists in clinical settings twards a mre hlistic apprach in which assessment in clinical practice permits the assessment f skills, attitudes, values and abilities, thus widening the assessment pprtunities available. In Canada, the framewrk fr Registered Nurses prvides a cmmn framewrk t the practice f nurses in Canada (Canadian Institute 2007). Of particular relevance in the ratinale fr such a framewrk is the relatively large number f unregulated care envirnments that nurses may practice in. The need fr explicit and clear understanding f practice learning cmpetencies is therefre arguably mre f a necessity. Registered Nurses are assessed by the regulatry bdy in the jurisdictin in which they live, althugh the cmpetencies are shared by all. Nurses and ther health prfessinals share cmmn grund in practice applicatin allwing fr greater verlap between prfessinals in educatin and learning. 18
Hwever 62% f nurses currently wrk in hspital settings s interprfessinal learning is currently cnfined largely t acute and secndary care services. Hwever the future f the prfessin, espused by Villeneuve and McDnald (2006), anticipates a greater fcus n cmmunity prvisin and a health service that is fcused arund cmmunity and scial determinants in health demgraphics. 2.9 Summary f Literature Review In summary, in terms f ther prfessinals, and the internatinal perspective explred, it seems that there is little evidence t indicate that prfessinals ther than the prfessinal discipline f the student, participates in the assessment prcess in anything ther than a mst nminal manner. The literature ffers n examples f where Due Regard has wrked well in implementing the flexibility ffered by the NMC t prviders in the (NMC 2010a; NMC 2011 a,b,c) standards and guidance. The literature regarding the assessment and supervisin f undergraduate nurses generally acknwledges that student learning in practice must perate beynd the mre traditinal bundaries f secndary and acute care practice learning settings if they are t develp the skills required t wrk in cntemprary health and scial care settings. Hwever it seems that this is very new territry fr bth academic and clinical partners and that the principle f Due Regard is interpreted as an abslute rather than in accrdance with the sfter and mre flexible advice prvided by the NMC (2011a) guidance and advice dcument. 19
SECTION 3: SURVEY AND DATA ANALYSIS 3.1 Findings f the Natinal On-Line Survey In rder t ascertain the views frm academic staff within Higher Educatin Institutins (HEI s) wh prvide pre-registratin nursing prgrammes in Sctland, an n line survey was set up using the survey mnkey tl. The aim f this survey was t review each institutin s experiences f Due Regard, and the use f ther registered prfessinals in their pre-registratin prgrammes (excluding Midwifery). This survey was nt annymus because the grup were specifically lking fr: Higher Educatin Institutins (HEI s) in Sctland s interpretatin f the NMC (2010a) standards, recmmendatins and guidance in relatin t Due Regard, and hw this is measured at institutin level; Instances where HEI s believe Due Regard r the use f ther registered prfessinals has been successfully applied; Instances where it has nt been pssible t apply Due Regard and hw this was addressed; Any specific challenges encuntered by HEI s and hw they had been reslved. This sectin f the reprt will display the answers frm the n-line survey in bth table frmat and direct qutes frm the pen ended questins and additinal cmments. Eighteen participants respnded t the survey frm nine HEI s in Sctland, hwever nt all respnded t each questin. 20
3.2 Demgraphics Questin 1: Which Higher Educatin Institutin d yu represent? The survey was distributed t all Higher educatin Institutins in Sctland wh prvide Preregistratin nursing educatin. Eighteen participants respnded frm nine universities. Figure 1 identifies which universities were represented and hw many respndents came frm each university. Figure 1: Representatin frm Higher educatin Institutins (n=18) Questin 2: Which field(s) f nursing d yu represent? Figure 2 utlines the pre-registratin prgrammes/fields f nursing that the respndents represented. Althugh nly 18 participants respnded sme were representative f mre than ne prgramme/field f nursing. Figure 2: Representatin frm fields f nursing (n=18) 21
Questin 3: What is yur rle within yur HEI? The survey was distributed thrugh Practice Learning Crdinatr/Lead and Prgramme Lead netwrks. Hwever cgnisance was taken f the different titles fr these rles in different HEIs. Therefre an ptin fr ther was prvided. The rles f the respndents within each HEI are utlined in figure 3 hwever thers included: Lecturer (n=1), Senir Lecturer Practice Learning, deputy fr the lead (n=1), Senir Lecturer respnsible fr BN prgramme (n=1), Teaching Fellw/ chrt lead (n=1), Vice Chair (n=1), Field lead (n=1), Deputy prgramme manager (n=1), Prgramme lead within Sctland (n=1), Quality & Enhancement Lead (n=1). Figure 3: Rle f participant (n=18) 3.3 Definitins and Interpretatin f Statements The Standards fr pre-registratin nursing educatin define due regard as Relates t student assessment in pre-registratin nursing prgrammes. If Due Regard is required, the assessr must be registered n the same part f the NMC register and have a mark in the same field f practice that the student intends t enter. (NMC, 2010a, p146) Hwever, in Sctland it is perceived that there are a number f challenges in applying Due Regard in pre-registratin prgrammes and incnsistencies in advice received frm the Nursing and Midwifery Cuncil (NMC). Therefre HEIs were asked t state hw they defined due regard within their wn prgrammes. 22
Questin 4: Hw des yur HEI define 'Due Regard'? There were thirteen respnses, a number f which used the NMC wrding in their definitin. Mentrs and practice teachers nrmally assess thers nly with due regard t the parts n which they, themselves are registered. (Directly frm NMC glssary). Due regard - mentr n the same part f the register (field) as the student t cmplete the practice assessment. Hwever there were a number f definitins which demnstrated a lack f clarity r understanding due regard mentrs assumes the accuntability fr the cmpetence achieved in practice. Other prfessinals mentring students. It is almst always prvided by a registered nurse n the same part f the register. Questin 5: R4.2.1 (NMC, 2010a, p63) states Practice learning prviders must ensure that a mentr r practice teacher is available t the student fr at least 40% f the time during perids f practice learning. What is yur interpretatin f 'available'? The respndents (n=14) interpretatin f available varied slightly but n the whle suggested it meant wrking 40 % f the time with the student, being n the same shift r being n the same premises. Student spends at least 40% f their rstered time with their mentr r assciate mentr. Wrking with the student. wrks n the same shift as the mentr fr at least 40% f the time. the mentr shuld be n shift with the student and be accessible t them. The student and the mentr are almst always n the same 'premises' e.g. cmmunity health centre. One respndent hwever demnstrated mre flexibility suggesting available culd be by phne. T us this means either in persn r by phne. 23
Questin 6: R4.2.2 (NMC, 2010a, p64) states Practice learning prviders must ensure that students are supervised directly r indirectly at all times during practice learning by a mentr, practice teacher r ther suitably prepared registered prfessinal. In additin, the NMC (Implementing the Standard fr pre-registratin nursing educatin FAQs, 2010, p2) states Examples f ther health care prfessinals may include ther health care prfessinals, a teacher r scial wrker. What is yur interpretatin f suitably prepared? Again the respndents (n=14) interpretatin f suitably prepared varied slightly. Five respndents stated they nly used registered nurses wh had undertaken NMC apprved mentrship training All mentrs have undertaken an NMC apprved preparatin curse. Our students are nt assessed directly r indirectly by nn-registered nurses. I dn t knw as this des nt happen in my HEI. We are currently nt "suitably preparing ther prfessinal", ther than the mentrship prgramme that we have fr the AHP's. If a student wrks with anther registered prfessinal we ensure that this is less than 2 days. If mre than 2 days they need t shw that they have dne a mentrship prgramme. Fr a practitiner t act as yur supervisr they must meet the fllwing criteria: Be qualified in the same field f practice as the ne in which yu are practising; Have cmpleted a minimum f ne year s pst-qualifying experience in the same field f practice as the ne in which yu are practising; Have cmpleted supervisr preparatin as specified in accrdance with statutry/prfessinal bdy standards where available; Cmply with any statutry bdy/prfessinal standards related t cntinuing t act as a supervisr, where specified; Have cmpleted an inductin with Other replies demnstrated mre flexibility, highlighting that if the ther registered prfessinal had cmpleted a prgramme cnsidered t prepare them t supprt learning in practice and are prvided with specific infrmatin abut the pre-registratin prgramme and utcmes then this is acceptable. Is aware f the learning needs and utcmes that the student is required t meet. Has the equivalent preparatin t that f a nurse mentr e.g. assessr/supervisr within their wn discipline. Smene wh has cmpleted the lcal mentrship prgramme r has cmpleted a similar prgramme elsewhere. Or, has evidence f having cmpleted sme mentrship educatin assciated with his/wn prfessinal develpment. They have infrmatin abut the bjectives and utcmes fr the student. They are recgnised within their sphere f practise and their rganisatin as able t educate a student in practice. At present the schl mentrship mdule, whatever the supervisr's backgrund That they have been prepared t supprt students either frm their wn prfessinal bdy and understand the principles f mentrship/supervisin that can be used t allw them t supprt ther students ut with their speciality (student nurses). 24
Questin 7: Hw des yur HEI assess/measure that ther registered prfessinals preparatin is apprpriate? Thse wh accepted ther registered prfessinals gave examples f hw their HEI assess/measure that ther registered prfessinals preparatin is apprpriate. These included accepting discipline specific training t supprt learners; received prir preparatin frm practice educatin team; liaisn lecturer assessment in the clinical area r specific mentrship prgramme fr AHPs/training. Is a teacher/assessr/supervisr within their wn discipline and has undertaken educatin and training within this rle t supprt their wn learners. Liaisn lecturing staff supprt students in practice and are n hand t liaise with PEF clleagues t ensure that mentrship is apprpriate. But in additin when students are with ther prfessinals they wuld have received prir preparatin frm a member f the practice educatin team. We have a mentrship prgramme fr AHPs at the university. One respnse stated they mapped their training against the NMC SLAiP. They are invited t map against the SLAiP standards using ur APEL tl. 3.4 Invlvement f Other Registered Prfessinals in Practice Learning and Assessment Questin 8: What d yu think suitable preparatin fr ther registered prfessinals (nt registered nurse mentrs) shuld include? Figure 4: Suitable preparatin fr ther registered prfessinals (n=14) 25
Participants were asked fr suggestins f what they cnsidered suitable preparatin fr ther registered prfessinals. Five respndents gave additinal suggestins t thse in the drp dwn menu. A mixture f APL and study. Infrmatin abut the specific learning requirements fr the students. A mix f all f the abve, achieved by RPL OR RPEL. If the student wishes t achieve academic credit fr the mdule partial RPL is nt pssible. I think it requires smething between an NMC apprved mentrship prgramme and a half day study day. Prbably t include an inductin t the NMC 2010 standards and with sme supervised input. Unlikely ther prfessinals will attend Mentrship Prgramme/Updates. Questin 9: Since validatin f yur new prgramme have yu had any students assessed at prgressin pint 1 by anyne ther than a registered nurse mentr? All respndents (n=14) said they had nt had any student assessed at prgressin pint 1 by anyne ther than a registered nurse mentr. Figure 5: Assessment at prgressin pint 1 by thers 26
Questin 10: R5.7 (NMC, 2010a, p75) states prgramme prviders must ensure that student have the pprtunity t learn with, and frm, ther health and scial care prfessinals. D yu ensure that students have the pprtunity t learn with, and frm ther healthcare prfessinals? Figure 6: Opprtunity t learn with thers All respndents (n=13) said they did ensure that students have the pprtunity t learn with, and frm ther healthcare prfessinals. Hwever, lking back at previus respnses this des nt appear t include mentrship and assessment in practice. Als the examples given predminantly related t theretical sessins. Within the university ur students link with scial wrk and medical students as well as thse frm educatin and a range f scial plicy areas. Shared mdules with students f ther prfessins e.g. scial wrk, AHPs. Shared learning with medical and scial care students. Insight learning and pathways - spke learning. Sessins frm dietician, physitherapist, epilepsy nurse. Dctrs scial wrkers health prmtin peple etc. AHPS, dieticians/physi/ccupatinal health/pdiatry/speech language team Radigraphers/ medical students/cnsultants health prmtin team/specialist practitiners, strke liaisn/ms nurse/cardiac rehab/public health team. Third sectr wrkers. 27
Questins 11, 12 and 13 fcused n ther prfessinals supervising students. Questin 11: What ther registered prfessinals d yu currently have supervising students in part 1 f the prgramme? Figure 7: Other registered prfessinals supervising students in Part 1 f the prgramme (n=13) It was indicated that a variety f ther registered prfessinals were supervising students in part 1 f the prgramme. Hwever additinal cmments suggested this was nly fr a few days r very ccasinally rather than a full practice learning allcatin. Als seven HEIs did nt have any ther registered prfessinals supervising students. Hwever the abve wuld supprt and supervise fr days nt fr whle placement, students always mentred by nurse/midwife/health visitr r schl nurse. Very ccasinally nly. All students are indirectly supervised by their mentr. But nly fr a shrt duratin, and nt assessing them, but feeding back t their registered nurse mentr. Nt supervising as such but engaging in learning experiences via the insight visits/inter-prfessinal learning/practice teachers DN/HVs. 28
Questin 12: What ther registered prfessinals d yu currently have supervising students in part 2 f the prgramme? Figure 8: Other registered prfessinals supervising students in Part 2 f the prgramme (n=13) Similar t questin 11 it was indicated that a variety f ther registered prfessinals were supervising students in part 2 f the prgramme. Hwever additinal cmments suggested this was nly fr a few days r very ccasinally rather than a full practice learning allcatin. Als there was an increase t eight HEIs that did nt have any ther registered prfessinals supervising students. Hwever the abve wuld supprt and supervise fr days nt fr whle placement, students always mentred by nurse/midwife/health visitr r schl nurse. Very ccasinally nly. nly fr a shrt duratin f up t 2 days and feeding back t the mentr. This is an issue especially fr LD since we wuld like them t have lnger practice experiences within the third sectr. Practice teachers/same field f practice as student. 29
Questin 13: What ther registered prfessinals d yu currently have supervising students in part 3 f the prgramme? Figure 9: Other registered prfessinals supervising students in Part 3 f the prgramme (n=13) Again similar t questin 11 and 12 it was indicated that a variety f ther registered prfessinals were supervising students in part 3 f the prgramme. Hwever additinal cmments suggested this was nly fr a few days r very ccasinally rather than a full practice learning allcatin. Eight HEIs did nt have any ther registered prfessinals supervising students. Hwever the abve wuld supprt and supervise fr days nt fr whle placement, students always mentred by nurse/midwife/health visitr r schl nurse. Very ccasinally nly, students n elective verseas. nly fr maximum f 2 days. Practice teachers/ same field f practice as student (DN s). Questins 14, 15 and 16 fcused n ther prfessinals assessing students. 30
Questin 14: What ther registered prfessinals d yu currently have assessing students in part 1 f the prgramme? Figure 10: Other registered prfessinals assessing students in Part 1 f the prgramme (n=13) Figure 10 identifies 12 respndents ut f 13 wh did nt have any ther registered prfessinals assessing students in part 1 f the prgramme. One HEI said they had teachers and scial wrkers but added in the cmments that it was nt them wh actually cmpleted the assessment - They give feedback t the mentr wh will undertake assessment. Questin 15: What ther registered prfessinals d yu currently have assessing students in part 2 f the prgramme? 100.0% 90.0% 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% Allied health care prfessinals Teachers Nursery teachers Nursery nurses Scial wrkers Nne Other Figure 11: Other registered prfessinals assessing students in Part 2 f the prgramme (n=13) Nne f the HEIs had ther registered prfessinals assessing students in part 2 f the prgramme. 31
Questin 16: What ther registered prfessinals d yu currently have assessing students in part 3 f the prgramme? Figure 12: Other registered prfessinals assessing students in Part 3 f the prgramme (n=13) Only ne HEI had ther registered prfessinals assessing students in part 3 f the prgramme and this was due t an verseas elective placement. verseas elective - staff prepared in advance by Wrk the Wrld r via Mem f agreement with the university. 3.5 Maintaining a Register, Annual Updates and Triennial Review fr Other Registered Prfessinals The NMC (2008, p.8) state: Placement prviders were identified as being respnsible fr develping and maintaining the lcal registers and undertaking triennial review. hwever, it has becme clear that sme smaller scale placement prviders, particularly the independent sectr (e.g. nursing hmes), may nt be best placed t undertake this respnsibility. NMC circular 28/2007 enabled educatin prviders t take respnsibility fr develping and maintaining lcal registers f mentrs/practice teachers, prviding annual updates, and undertaking triennial reviews, as apprpriate, thrugh negtiatin with small scale prviders with whm they wrk in partnership. 32
Questin 17: Des yur HEI keep a database f ther registered prfessinals (nn-registered nurse)? Figure 13: Database f ther registered prfessinals (n=13) Three HEIs had a database/register f ther registered prfessinals (nn-registered nurse). Questin 18: D yu prvide ther registered prfessinals with annual updates? Figure 14: Annual updates fr ther registered prfessinals (n=13) Fur HEIs prvided annual updates fr ther registered prfessinals. Belw are examples f hw this is facilitated. I have had a very few examples f AHPs requesting t sit in n annual mentr update sessins given at a ward/unit level - rare but has happened. Overseas elective - staff supprting elective students, many thrugh Wrk the Wrld, are supprted by WtW staff wh are, in turn, annually invited t a prep day within the University. 3 hur preparatin fr practice sessin nce yearly. Updates are prvided fr all staff grups t access. 33
Questin 19: D yu mnitr the triennial review f ther registered prfessinals? Figure 15: Mnitring triennial review fr ther registered prfessinals (n=13) One HEI stated that they mnitred triennial review fr ther registered prfessinals but nt fr the new curriculum. Same prcess as fr all mentrs but in C12 this is nt necessary. Questin 20: Are these ther registered prfessinals supervised by a registered nurse mentr? Figure 16: Supervisin f ther registered prfessinals by registered nurses (n=13) Again the same university that answered yes in questin 19 stated the ther registered prfessinals were supervised by a registered nurse but in the previus prgramme nt the current prgramme. Hub and spke arrangement but nt fr C12. 34
3.6 Plicy and Audit Questin 21: D yu have a practice learning plicy fr situatins where Due Regard cannt be applied and students are supervised by ther registered prfessinals? Figure 17: Supervisin f ther registered prfessinals by registered nurses (n=12) Nne f the HEIs that respnded had a plicy r guideline fr situatins where due regard cannt be applied and students are supervised by ther registered prfessinals. Questin 22: With regards t yur practice learning experience audit, what prfessinals d yu recrd in the mentr numbers sectin? Figure 18: Recrding f ther registered prfessinals in audits (n=12) 35